INTRODUÇÃO E OBJETIVOS: A Encefalite de Rasmussen (ER) é caracterizada por epilepsia intratável, hemiparesia progressiva e atrofia hemisférica unilateral. A progressão dos sintomas geralmente ocorre em meses ou poucos anos. As drogas antiepilépticas são usualmente ineficazes no controle da progressão da doença e o tratamento cirúrgico, com desconexão hemisférica tem sido considerado o tratamento de escolha. Neste trabalho descreveremos os achados clínicos e eletrográficos, assim como a evolução pós-operatória de pacientes com ER. PACIENTES E MÉTODOS: foram incluídos todos os pacientes com ER avaliados no período de janeiro de 1995 a janeiro de 2008, no Centro de Cirurgia de Epilepsia de Ribeirão Preto (CIREP), sendo considerados os dados demográficos, os achados do eletrencefalograma (EEG) interictal e ictal, resultado anatomo-patológico e o seguimento clínico. RESULTADOS: Vinte e cinco pacientes foram avaliados, 13 eram do sexo feminino. A idade média de início da epilepsia foi de 4.4±2.0 anos. Não houve diferenças significativas entre os pacientes com evolução lenta ou rápida considerando-se a idade de início da epilepsia (p=0,79), idade da cirurgia (p=0,24), duração da epilepsia (p=0,06) e tempo de seguimento (p=0,40). Não houve correlação entre a presença de alterações bilaterais ou ausência de descargas ao EEG e o seguimento pós-operatório (p=0,06). Vinte e três pacientes foram submetidos à cirurgia. O tempo médio de seguimento foi de 75,3 meses. Onze pacientes evoluíram com controle total das crises. Doze pacientes permaneceram com crises que consistiram de clonias faciais sutis (6 pacientes), crises tônico-clônicas hemigeneralizadas ocasionais (3 pacientes) ou crises tônico-clônicas frequentes (3 pacientes). Alterações cognitivas e de linguagem foram observadas em 15 e 12 pacientes após a cirurgia, respectivamente. CONCLUSÕES: este estudo retrospectivo relatou os achados clínicos, eletrográficos e a evolução de 23 pacientes. Controle satisfatório das crises foi obtido em 14 pacientes. Três pacientes tiveram resposta parcial com a cirurgia e cinco pacientes mantiveram o quadro pré-operatório. Todos os pacientes com envolvimento do hemisfério cerebral esquerdo evoluíram com distúrbio de linguagem e cognitivo.

BACKGROUND AND PURPOSE: Rasmussen Encephalitis (RE) is characterized by intractable epilepsy, progressive hemiparesis and unilateral hemispheric atrophy. The progression of the symptoms usually occurs within months to few years. Antiepileptic drugs are usually not effective to control disease progression and epilepsy surgery in the form of hemispheric disconnection has been considered the treatment of choice. This work describes the clinical and electrographic analyses, as well as the post-operative evolution of patients with RE. PATIENTS AND METHODS: This work includes all the patients with RE evaluated from January 1995 to January 2008 by the Ribeirão Preto Epilepsy Surgery Program (CIREP) considering demographic data, interictal and ictal electroencephalographic (EEG) findings; anatomo-pathological findings and clinical outcome. RESULTS: Twenty-five patients were evaluated, thirteen were female. Mean age of epilepsy onset was 4.4±2.0 years. There were no differences between patients with slow and fast evolution with respect to age of epilepsy onset (p=0.79), age at surgery (p=0.24), duration of epilepsy (0.06), and follow-up (p=0.40). There were no correlations between the presence of bilateral EEG abnormalities or the absence of spikes and post-operative seizure outcome (p=0.06). Twenty-three patients underwent surgery. The mean follow-up was 75.3 months. Eleven patients had total seizure control. Twelve individuals persisted with seizures consisting of mild facial jerks (6 patients), occasional hemigeneralized tonic-clonic seizures (3 patients), and frequent tonic-clonic seizures (3 patients). Mental and language impairment was observed in 15 and 12 patients, after surgery, respectively. CONCLUSIONS: This retrospective study reported the clinical and electrographic analysis, as well as the evolution of 23 patients with RE. Fourteen patients achieved satisfactory seizure control, three patients had partial response to surgery, and five patients had maintenance of the pre-operative condition. All patients with left side involvement presented with some language and cognitive disturbance.

De los 9 casos de fascioliasis humana registrados en Venezuela, 4 han sido publicados en los últimos 10 años, siendo 2 de éstos procedentes de la región andina. El riesgo de endemicidad frecuente en bovinos y la condición clínica de una niña de 14 años, con malestar abdominal, vómitos, eosinofilia y antecedentes de ingestión abundante de berros, motivó realizar un estudio en su lugar de procedencia (Timotes, Edo. Mérida), para conocer la exposición de la comunidad al riesgo de infección. Se evaluaron 65 personas, a quienes se les realizó historia clínica, con consentimiento previa información, toma de muestras de sangre, exámenes de heces (n=37) y ecografía abdominal (n=33). Se practicó ELISA con extracto soluble de adultos de Fasciola hepatica (ELISA-AFhES), resultando 9 personas positivas. Se practicó "Western blot" (WB) a todos los sueros positivos en ELISA, de los cuales 5 reconocieron moléculas específicas de 9, 14, 27 y 65 kDa, lo que constituye un patrón de positividad al WB. Los cuatro sueros restantes, con débil reactividad al ELISA, no reconocieron estas moléculas. Por estudios coprológicos se encontraron Entamoeba coli, Entamoeba histolytica/dispar, Blastocystis hominis, Giardia lamblia, Endolimax nana y Ascaris lumbricoides. Tres de las 5 personas positivas por ELISA-AFhES y WB-AFhES resultaron con huevos de Fasciola hepatica en las heces. Los 5 casos positivos corresponden a niñas de una familia, todas hermanas, cuyos padres resultaron sin infección, a pesar de que todos ingieren berros y ensaladas con productos de la región. El presente estudio constituye el primer reporte de transmisión a humanos en una población de un área bien delimitada en la región andina venezolana.

Of the 9 cases of human fascioliasis recorded in Venezuela, 4 have been published in the last 10 years, 2 of them originating from Andean region. The well known transmission of fascioliasis in cattle and the clinical condition of a 14-year-old girl with abdominal discomfort, vomiting, eosinophilia and previous abundant ingestion of watercress, motivated the field study in the site of occurrence (Timotes, Edo. Mérida in the Andean region) to learn the risk of community infection. Sixty-five people were evaluated clinically and serologically. Coprology was done in 37 and abdominal ultrasound in 33 persons. ELISA with adult Fasciola hepatica soluble extract (AFhES- ELISA) was performed with 9 persons being positive. Western blot (WB) was carried out on all ELISA positive sera, resulting in 5 that recognized 9, 14, 27 and 65 kDa specific molecules. The remaining four sera, with weak reactivity by ELISA, did not have this recognition pattern. By stool examination, we found Entamoeba coli, E. histolytica/dispar, Blastocystis hominis, Giardia lamblia, Endolimax nana and Ascaris lumbricoides. Three of the 5 positive people by AFhES-ELISA and AFhES-WB had F. hepatica eggs in their feces. The 5 positive cases are girls of a family, sisters and whose parents do not have the infection, although all consume watercress in salads with other vegetables from that region. The present study constitutes the first report of a well established focus of fascioliasis with human repercussion in Venezuela.

Se estudió la condición hepática y algunas características hematológicas y bioquímicas de truchas arcoiris de diferentes edades. Se utilizaron 30 ejemplares de cada grupo de edad (13, 20, 28, 31, 37, 44, 48, 55, 64 y 73 meses) del plantel de reproductores del Campo La Mucuy, ubicada en el Parque Nacional Sierra Nevada, en el estado Mérida, Venezuela. Se determinó peso corporal y peso del hígado para estimar el Indice Hepatosomático (IHS). La condición hepática (CH) macroscópica se estableció haciendo referencia a un hígado aparentemente sano. Las muestras para histología fueron colocadas en formol a los 10%, procesadas en parafina y coloreadas en hematoxilina-eosina. Se tomaron muestras de sangre para determinar hemoglobina, hematocrito y aminotransferasas, en sus dos formas: aspartato aminotransferasa y alanina aminotransferasa. El IHS de las truchas con tumores (P<0,05) fue significativamente más alto que aquellas con hígado aparentemente normal, coloración anormal y manchas, pero en estas últimas no hubo diferencias significativas. La CH macroscópica de las truchas con edades entre 13 y 20 meses fue 100% normal. En ese mismo grupo el estudio histológico reportó un 3,3% de hepatocarcinoma en ejemplares de 20 meses de edad. A partir de esta edad la normalidad descendió alcanzando valores más bajos en las edades entre 55 y 73 meses. Se encontró una relación positiva con r²= 0,499 (P<0,05) entre la CH y la edad. El hematocrito de las truchas con tumores y manchas fue significativamente menor (P<0,05) que las truchas normales y con color anormal; a partir de los 28 meses de edad disminuyó alcanzando su mínimo valor a los 73 meses. Mientras que los valores de hemoglogina fueron similares al relacionarlos con la CH, las truchas de 73 meses presentaron un valor de hemoglobina significativamente menor que todos los demás grupos. Se encontraron diferencias significativas entre las aminotransferasas de las truchas con hígado normal y las que presentaron manchas y tumores. La actividad de estas enzimas fue significativamente mayor en los machos que en las hembras.

This research was carried out in the National Park Sierra Nevada in Mérida, Venezuela. The objective was to study the hepatic condition and some biochemical and hematology variables of rainbow trout of different age. There were utilized 300 animals of 13 to 73 months of age, was establish ten lots of each ages. Was determined body weight and liver weight for to esteem hepatosomatic index. The macroscopic condition hepatic was established making reference to healthy liver, any different form was considered abnormal. Samples of blood were taken to determine haematocrit, haemoglobin and aminotransferase (aspartate and alanine). The hepatosomatic index of the trout with liver tumors was significantly greater than the normal liver, abnormal coloration and spot. The macroscopic condition hepatic of the rainbow trout between 13 and 20 months old was normal. The histology study reports 3.3% hepatic carcinoma in the twenty months old group. From this age to forward the values were falling with the lowest values between the ages of 55 to 73 months. The relation between hepatic condition and the age indicated positive a lineal relationship with r²= 0,499 (P<0.05). Rainbow trout haematocrit with tumors and spot were significantly lower than the normal liver and abnormal coloration. From twenty eight months old it was to go down to the trout of 73 months old. The haemoglobin was similar in all condition hepatic, but haemoglobin of the trout of 73 months old presented valor significantly lower than the others group. The aminotransferase of trout with normal liver was significantly greater than trout with spot and tumors. The enzymatic activity of alanine and aspartate aminotransferase was higher in the male than in the female.

Male mice (NMRI strain) of 3 and 5 g were inoculated i. p. with 8 x 10(6) and 9 x 10(4) metatrypomastigotes/g harvested from a 12-day-old LIT culture of Trypanosoma rangeli of the "Dog-82" strain. At regular intervals after inoculation, the animals were sacrificed and portions of heart, liver, spleen, lung, thigh, kidney, stomach, intestine, brain, sternum, and vertebral column were embedded in paraffin, sectioned, and stained with haematoxylin-eosin and Giemsa colophonium. Pathology was encountered in the first five tissues cited above. The subcutaneous, periosteal, interstitial, and peribronchial connective tissues, and later the muscle cells of the heart, were heavily parasitized by amastigotes and trypomastigotes. The possible reasons for the decrease in tissue parasitosis at the same time that the parasitemia is reaching its peak, and for the low level of inflammation in the parasitized tissues, are discussed. The observations of other workers, as well as the results described here, indicate that certain strains of T. rangeli under certain conditions may well cause pathological alterations in mammals.

Ratones machos (cepa NMRI) de 3 y 5 gr, inoculados i.p. con 8 x 10(6) y 9 x 10(4) metatripo- mastigotes/gr cosechados de cultivo LIT de 12 días de repique de la cepa "Perro-82" de Trypanosoma rangeli fueron procesados, em determinados períodos postinoculación, para seccionar y teñir con hematoxilina-eosina y Giemsa-colofonio trozos de corozón, hígado, bazo, pulmones, fémur, riñon, intestino, estómago, cerebro, cerebelo, esternón y columna vertebral. Se detallan los resultados preliminares sobre la histopatologia provocada por el T. rangeli en los cinco primeros órganos citados. Los tejidos conjuntivos subcutáneo, periosteal, intersticial y peribronquial, así como las miocélulas del corazón fueron altamente parasitados por amastigotes y tripomastigotes. Se discuten las posibles razones de la disminución del parasitismo tisular cuando la parasitemia se encontró en sus niveles máximos, así como la escasa inflamación obtenida en los tejidos parasitados. Las observaciones de varios autores sobre el comportamiento del protozoario en humanos y en animales de laboratorio así como los resultados descritos en este trabajo, plantean la posibilidad de que determinadas cepas de T. rangeli, en condiciones particulares, podrían causar alteraciones patológicas en el mamífero.

Faz-se uma revisão das espécies de Haemogregarina, encontradas, até a presente data, em Bufo marinus L. da região Norte, Leste e Sul da Venezuela,descrevendo-se o ciclo agâmico da Haemogregarina darlingi Leger, 1918, o ciclo esquizogônico da Haemogregarina aquai Phisalix, 1930, propondo-se seja denominada Karyolysus aquai (Phisalix) por realizar o ciclo agâmico nas células endoteliais. Descreve-se a Haemogregarina legeri nov. sp. Estuda-se um Toxoplasma no sangue e vísceras de Bufo marinus L., descrevendo-se a anatomia patológica dos órgãos afetados, discutindo-se o estado atual da sistemática das espécies de Toxoplasma, parasitos de vertebrados poikilotermos, propondo-se o nome de Toxoplasma serpai nov. sp. para êste protozoário.

A revision is made of the species of Haemogregarina found up to now in Bufo marinus L. from the Neotropical Region. Parasites in toads from the north, center, south and east of Venezuela are studied and descriptions are made of the agamic cycle of Haemogregarina darlingi Leger 1918; the schizogonic cycle of Haemogregarina aquai Phisalix 1930, proposing reclassify it as Karyolysus aquai (Phisalix) since its agamic cycle is carried through in endothelial cells, and Haemogregarina legeri nov. sp. A Toxoplasma is studied in the blood and viscera of Bufo marinus L. describing the pathology of affected organs, proposing the name Toxoplasma serpai nov. sp. for it. The actual state of the systematics of Toxoplasma parasites in poikilotherm vertebrates is discussed.

Se hace una revisión de las especies de Haemogregarina encontradas hasta el presente en Bufo marinus L. de la región neotrópica, estudiando estos parásitos en sapos del centro, norte, oriente y sur de Venezuela, describiendo el ciclo agamico de la Haemogregarina darlingi Leger 1918, el ciclo esquizogonico de la Haemogregarina aquai Phisalix 1930, proponiendo denominaria Karyolysus aquai (Phisalix) por realizar su ciclo agámico en las células endoteliales. Se describe la Haemogregarina legeri nov. sp. Se estudia un Toxoplasma en la sangre y visceras de bufo marinus L. describiendo la anatomia patológica de los órganos afectados, discutiendose el estado actual de la sistematica de Toxoplasma parasitos de vertebrados poikilotermos, proponiendo el nombre de Toxoplasma serpai nov. sp. para este protozoario.

Es wird eine Revision von den bisher in bufo marinus L. gefundenen Haemogregarina-Arten in der neotropischen Region zusammengefasst. Die genannten Parasiten wurden in den Kröten der zentralen, nördlichen, östlichen und südlichen venezuela studiert. Der agamische Zyclus von Haemogregarina darlingi Langer 1918 und der schizogonische Zyclus von Haemogregarina aquai Phisalix 1930 wurde beschrieben, was als Karyolysus aquai (Phisalix) zu nennen vorgeschlagen wurde, da er seinen agamischen Zyclus in endotelialen Zellen vollbringt. Man beschreibt Haemogregarina legeri sp. n. Man erforscht ein Toxoplasma im Blut und Eingeweiden von Bufo marinus L., beschreibend die patologische Anatomie der befallenen Organen, erörtend den jetzigen Zustand über Sistematik der Toxoplasma-Parasiten von poikolithermen Wirbeltieren. Es wird der Name Toxoplasma serpai sp. n. für den genannten Einzeller vorgeschlagen.